farther particulars of a case of pneumato- thorax. 26 1 
oesophagus was similar. The pericardium was firmly at- 
tached to the middle lobe of the right lung by a firm band 
of adhesion. On exposing to view the left cavity of the 
chest, the inside of the pleura exhibited a surface of milk- 
white granular coagulable lymph, about two lines thick, 
equally diffused on the costal and the pulmonic side. Ex- 
cepting the cicatrices externally in the skin, no traces could 
be detected of the two first operations, nor was there any 
mark of the last operation, exclusive of the small opening, 
which had been carefully kept open, just large enough to 
admit the trochar, which had been daily introduced to draw 
off the fluid, and allow the air to escape. On maceration of 
the rib, it may be remarked, a very narrow ring of bone was 
found exfoliating from the perforated part. The left lung 
was very much condensed, and so firmly confined by its 
thickened pleura, that it did not dilate when air was driven 
into it with some force by a double bellows attached to the 
trachea. This experiment was made with the lung under 
water, for the purpose of ascertaining if any, and what kind 
of communication, existed between the lung and the pleura, 
with a view to discover the origin of the air accumulated in 
this cavity. Two communications were thus detected ; one 
in the inferior, the other in the superior lobe. The former 
was so exceedingly small that it could not be traced. The 
latter opening was sufficiently large to admit a surgeon's 
probe, and its course was easily followed ; it was found to 
communicate directly and obliquely with a ruptured opening 
in the side of a large bronchial tube, situated immediately 
under the pleura. The adjoining pulmonary substance 
appeared to be merely condensed from compression. The 
